Medial Epicondylitis
About
Medial epicondylitis commonly affects golfers, baseball pitchers and almost anyone who overuses his or her wrist or elbow during work or sports. In the case of baseball, think of a pitcher winding up, throwing his arm back and releasing the ball as he brings his arm round and snaps his wrist downwards. This motion is wrist flexion. If the pitcher wants the ball to curve to the side he's throwing from (what pitchers call a screw ball), he'll have to snap his wrist inward as well, as if he were unscrewing a light bulb. This motion is wrist pronation. Movements combining flexion and pronation are the major cause of medial epicondylitis.
Patients with the condition feel pain in the elbow, on the inside where there's a bony bump. They also commonly have an ache or pain around the inside of their elbow joint and possibly in the surrounding muscles. When they lift their wrist with the palm up, as if they were picking up a table, the pain worsens, and movements that involve flexion or pronation can be unbearable.
Any activity that involves repetitive flexion and pronation, like hammering, golfing and playing tennis, can lead to medial epicondylitis. During these activities, excessive force on the wrist flexors, which are muscles that connect the wrist to the elbow, can strain the inner part of the elbow joint. The body reacts to this strain with painful inflammation.
If left untreated, the condition can become chronic, so it's important to see your healthcare practitioner if you're experiencing symptoms of medial epicondylitis. He or she will use a variety of management techiniques and may prescribe exercises to support and strengthen the elbow joint.
Anatomy
When pitchers toss a ball, it may look like their shoulders are doing most of the work. But without subtle wrist and elbow movements, the ball won't get too far. If you hold your arm out straight and move it up and down at the shoulder, you'll see why. Your elbow and wrist need to move freely, like a whip, in order for you to throw a successful pitch. To perform this motion, a pitcher's wrist goes through flexion (forward bending, so his or her fingers are pointing down) and pronation (inward turning, as if he or she were unscrewing a light bulb).
Wrist flexor muscles are responsible for these movements, and they start at your wrist, run along the inside of your arm and attach to the main tendon in your elbow, the common flexor tendon. The common flexor tendon then runs from the end of the wrist flexor to the medial epicondyle, which is the bump you see on the inside of your elbow when you flex your bicep muscle.
Medial epicondylitis involves inflammation of the medial epicondyle and its surrounding tendons and soft tissues. When you flex your wrist or use your hand to grip something, the wrist flexor muscles contract and pull against the common flexor tendon. When you repeat such movements and combine them with pronation, as pitchers do when throwing screw balls, it places strain on the flexor muscles and pulls on the common flexor tendon and the medial epicondyle.
If you perform these movements repeatedly, the overused flexor muscles develop small tears and eventually scar tissue. It's this damage that makes the inside of your elbow feel tender and painful, and causes irritation that can radiate down your forearm.
While baseball and golf commonly lead to such irritation, repetitive flexion and pronation are common elements of daily activities. Even business travelers who carry luggage can develop the condition, as they must constantly maintain their grip.
|
 |
3D Spine Simulator
Launch 3D Spine Simulator